Maternal Strangulated Diaphragmatic Hernia with Gangrene of the Entire Stomach During Pregnancy: A Case Report and Review of the Recent Literature.

Background: Bochdalek hernia (BH) of congenital diaphragm hernia is infrequently seen in adults. Strangulation of the diaphragm hernia has been recognized as a severe complication. Among several factors, pregnancy is an important cause of diaphragm hernia's deterioration. However, nausea, vomiting, and upper abdominal pain are often considered non-specific pregnancy-related symptoms. Case Presentation: We report a case of a 39-year-old (gravida II, para I) multigravida woman with a delayed diagnosis of strangulated herniated viscera complicating total gastric gangrene at 26+1 weeks' gestation. The preoperative diagnosis was confirmed by an X-ray examination and magnetic resonance imaging (MRI). After identifying the size and severity of the herniated contents through video-assisted thoracoscopy (VAT), we immediately converted to abdominal laparotomy. Antenatal corticosteroids were administered simultaneously with diagnosis to promote fetal maturity. The fetal condition was maintained well in the maternal uterus during the operation. Careful monitoring of the fetus and the mother's clinical conditions should be performed during expectant management to achieve delayed delivery after maternal surgical correction. Delivery was completed through cesarean delivery at 27+1 weeks of gestation. Conclusion: Despite the rarity of maternal Bochdalek hernias during pregnancy, early diagnosis and appropriate treatment via multidisciplinary care are essential for maternal and fetal outcomes.

Hyperactivation of YAP/TAZ Drives Alterations in Mesangial Cells through Stabilization of N-Myc in Diabetic Nephropathy.

SIGNIFICANCE STATEMENT: Mesangial cells (MCs) in the kidney are essential to maintaining glomerular integrity, and their impairment leads to major glomerular diseases including diabetic nephropathy (DN). Although high blood glucose elicits abnormal alterations in MCs, the underlying mechanism is poorly understood. We show that YAP/TAZ are increased in MCs of patients with DN and two animal models of DN. High glucose directly induces activation of YAP/TAZ through the canonical Hippo pathway in cultured MCs. Hyperactivation of YAP/TAZ in mouse MCs recapitulates the hallmarks of DN. Activated YAP/TAZ bind and stabilize N-Myc, one of the Myc family. N-Myc stabilization leads to aberrant enhancement of its transcriptional activity and to MC impairments. Our findings shed light on how high blood glucose in diabetes mellitus leads to DN and support a rationale that lowering blood glucose in diabetes mellitus could delay DN pathogenesis. BACKGROUND: Mesangial cells (MCs) in the kidney are central to maintaining glomerular integrity, and their impairment leads to major glomerular diseases, including diabetic nephropathy (DN). Although high blood glucose elicits abnormal alterations in MCs, the underlying molecular mechanism is poorly understood. METHODS: Immunolocalization of YAP/TAZ and pathological features of PDGFRß + MCs were analyzed in the glomeruli of patients with DN, in Zucker diabetic fatty rats, and in Lats1/2i ΔPß mice. RiboTag bulk-RNA sequencing and transcriptomic analysis of gene expression profiles of the isolated MCs from control and Lats1/2iΔPß mice were performed. Immunoprecipitation analysis and protein stability of N-Myc were performed by the standard protocols. RESULTS: YAP and TAZ, the final effectors of the Hippo pathway, are highly increased in MCs of patients with DN and in Zucker diabetic fatty rats. Moreover, high glucose directly induces activation of YAP/TAZ through the canonical Hippo pathway in cultured MCs. Hyperactivation of YAP/TAZ in mouse model MCs recapitulates the hallmarks of DN, including excessive proliferation of MCs and extracellular matrix deposition, endothelial cell impairment, glomerular sclerosis, albuminuria, and reduced glomerular filtration rate. Mechanistically, activated YAP/TAZ bind and stabilize N-Myc protein, one of the Myc family of oncogenes. N-Myc stabilization leads to aberrant enhancement of its transcriptional activity and eventually to MC impairments and DN pathogenesis. CONCLUSIONS: Our findings shed light on how high blood glucose in diabetes mellitus leads to DN and support a rationale that lowering blood glucose in diabetes mellitus could delay DN pathogenesis.

Gatekeeping role of Nf2/Merlin in vascular tip EC induction through suppression of VEGFR2 internalization.

In sprouting angiogenesis, the precise mechanisms underlying how intracellular vascular endothelial growth factor receptor 2 (VEGFR2) signaling is higher in one endothelial cell (EC) compared with its neighbor and acquires the tip EC phenotype under a similar external cue are elusive. Here, we show that Merlin, encoded by the neurofibromatosis type 2 (NF2) gene, suppresses VEGFR2 internalization depending on VE-cadherin density and inhibits tip EC induction. Accordingly, endothelial Nf2 depletion promotes tip EC induction with excessive filopodia by enhancing VEGFR2 internalization in both the growing and matured vessels. Mechanistically, Merlin binds to the VEGFR2-VE-cadherin complex at cell-cell junctions and reduces VEGFR2 internalization-induced downstream signaling during tip EC induction. As a consequence, nonfunctional excessive sprouting occurs during tumor angiogenesis in EC-specific Nf2-deleted mice, leading to delayed tumor growth. Together, Nf2/Merlin is a crucial molecular gatekeeper for tip EC induction, capillary integrity, and proper tumor angiogenesis by suppressing VEGFR2 internalization.

Existence of nontrivial weak solutions for a quasilinear Choquard equation.

We are concerned with the following quasilinear Choquard equation: [Formula: see text] where [Formula: see text], [Formula: see text] is the p-Laplacian operator, the potential function [Formula: see text] is continuous and [Formula: see text]. Here, [Formula: see text] is the Riesz potential of order [Formula: see text]. We study the existence of weak solutions for the problem above via the mountain pass theorem and the fountain theorem. Furthermore, we address the behavior of weak solutions to the problem near the origin under suitable assumptions for the nonlinear term f.

Relationship Between Grip and Pinch Strength and Activities of Daily Living in Stroke Patients.

OBJECTIVE: To investigate the relationship between grip and pinch strength and independence in activities of daily living (ADL) in stroke patients. METHODS: Medical records of 577 stroke patients from January 2010 to February 2013 were retrospectively reviewed. Patients' grip and pinch strength of both hemiplegic and non-hemiplegic hands and the Korean version of Modified Barthel Index (K-MBI) score were collected. These patients were divided into three groups: group A (onset duration: ≤3 months), group B (onset duration: >3 months and <2 years), and group C (onset duration: ≥2 years). The correlation between grip and pinch strength and the K-MBI score was analyzed. RESULTS: In group A (95 patients), the K-MBI score was significantly (p<0.05) correlated with the grip and pinch strength of both hands in patients with right hemiplegia. Significant (p<0.05) correlation between the K-MBI score and the grip and pinch strength of the hemiplegic hand was shown in patients with left hemiplegia. In group B (69 patients) and group C (73 patients), the K-MBI score was significantly (p<0.05) correlated with the grip and pinch strength of the hemiplegic hand. CONCLUSION: Stroke patients in subacute stage mainly performed activities of daily living using their dominant hand. However, independence in ADL was associated with the strength of the affected dominant hand. For stroke patients in chronic and late chronic stages, their hand power of the affected hand was associated with independence in ADL regardless whether the dominant hand was affected.

Butanol Dehydration over V2O5-TiO2/MCM-41 Catalysts Prepared via Liquid Phase Atomic Layer Deposition.

MCM-41 was used as a support and, by using atomic layer deposition (ALD) in the liquid phase, a catalyst was prepared by consecutively loading titanium oxide and vanadium oxide to the support. This research analyzes the effect of the loading amount of vanadium oxide on the acidic characteristics and catalytic performance in the dehydration of butanol. The physical and chemical characteristics of the TiO2-V2O5/MCM-41 catalysts were analyzed using XRF, BET, NH3-TPD, XRD, Py-IR, and XPS. The dehydration reaction of butanol was performed in a fixed bed reactor. For the samples with vanadium oxide loaded to TiO2/MCM-41 sample using the liquid phase ALD method, it was possible to increase the loading amount until the amount of vanadium oxide reached 12.1 wt %. It was confirmed that the structural properties of the mesoporous silica were retained well after titanium oxide and vanadium loading. The NH3-TPD and Py-IR results indicated that weak acid sites were produced over the TiO2/MCM-41 samples, which is attributed to the generation of Lewis acid sites. The highest activity of the V2O5(12.1)-TiO2/MCM-41 catalyst in 2-butanol dehydration is ascribed to it having the highest number of Lewis acid sites, as well as the highest vanadium dispersion.

The effect of rheological properties of foods on bolus characteristics after mastication.

OBJECTIVE: To evaluate the effects of physical properties of foods on the changes of viscosity and mass as well as the particle size distribution after mastication. METHOD: Twenty subjects with no masticatory disorders were recruited. Six grams of four solid foods of different textures (banana, tofu, cooked-rice, cookie) were provided, and the viscosity and mass after 10, 20, and 30 cycles of mastication and just before swallowing were measured. The physical properties of foods, such as hardness, cohesiveness, and adhesiveness, were measured with a texture analyzer. Wet sieving and laser diffraction were used to determine the distribution of food particle size. RESULTS: When we measured the physical characteristics of foods, the cookie was the hardest food, and the banana exhibited marked adhesiveness. Tofu and cooked-rice exhibited a highly cohesive nature. As the number of mastication cycles increased, the masses of all foods were significantly increased (p<0.05), and the viscosity was significantly decreased in the case of banana, tofu, and cooked-rice (p<0.05). The mass and viscosity of all foods were significantly different between the foods after mastication (p<0.05). Analyzing the distribution of the particle size, that of the bolus was different between foods. However, the curves representing the particle size distribution for each food were superimposable for most subjects. CONCLUSION: The viscosity and particle size distribution of the bolus were different between solid foods that have different physical properties. Based on this result, the mastication process and food bolus formation were affected by the physical properties of the food.

Asymmetry of the isokinetic trunk rotation strength of korean male professional golf players.

OBJECTIVE: To determine whether there is side to side difference of the trunk rotation muscle in Korean male professional golf players. Healthy controls who did not play golf were also evaluated and compared with professional golf players. METHOD: Fifty-one professional golf players and 50 healthy controls participated in this study. Bilateral isokinetic trunk rotation strength that represented the aiming side and non-aiming side trunk rotator function in a golf swing and other parameters were evaluated using the Biodex System III Isokinetic Dynamometer at angular velocities of 30, 60, and 120 degree per second. RESULTS: The professional golf players' peak torque and total work on their aiming sides were significantly higher than on their non-aiming side at all angular velocities. Additionally, the golf players' peak torque on their aiming side was significantly higher than those of the healthy controls only at the 60 degree per second angular velocity, but there was a slight and consistent trend in the others. Finally, the difference between the aiming side and the non-aiming side of the professional golf players and the healthy controls was also significant. CONCLUSION: The aiming side rotation strength of the male professional golf players was higher than that of non-aiming side. The controls showed no side-to-side differences. This finding is attributed to the repetitive training and practice of professional golf players. A further study is needed to investigate if the strengthening of the trunk rotation muscle, especially on the aiming side, could improve golf performance.

Central auditory processing impairment in patients with temporal lobe epilepsy.

In temporal lobe epilepsy (TLE) there may be functional abnormalities or structural lesions that can manifest as a central auditory processing disorder, which is defined as a disorder in the recognition, discrimination, ordering, grouping, and localization of sounds, with emphasis on the processing of nonspeech sounds. We performed frequency pattern, duration pattern, and dichotic tests in 28 patients with TLE with normal hearing on pure tone audiometry. The scores on the frequency pattern, duration pattern, and dichotic tests were abnormal in 78.6, 57.1, and 20.6% of patients, respectively, with no significant differences with the laterality of TLE. Patients with hippocampal sclerosis performed significantly worse than patients with normal MRI findings in frequency tests. Longer duration of epilepsy is negatively correlated with both the duration pattern and dichotic tests (P<0.05). Our results suggest that patients with TLE may be at risk for impairment of central auditory processing, which is increased in patients with hippocampal sclerosis or a longer duration of epilepsy.